[Note: Studies indicate 94% of ‘chronic fatigue syndrome’ (ME/CFS) patients suffer with muscle pain, 84% joint pain, and 80% headache - and pain is a key factor in disability levels. The full text of this report summarizing current knowledge regarding the nature and importance of pain in ME/CFS is available free at http://www.painphysicianjournal.com/2012/september/2012;15;E677-E686.pdf.

Pain increases during exercise [are] probably due to the lack of endogenous analgesia [body's natural pain modulation] and activation of several genes in response to exercise in CFS.

There is currently no evidence in support for the efficacy of complementary medicine in the treatment of pain from CFS.

Intensive education about the biology of pain from CFS (within the framework of central sensitization) has positive short-term effects for patients with CFS, and fatigue-targeting cognitive behavioral therapy appears to be effective for pain from CFS as well.

Limitations:

• The role of the deficient hypothalamus-pituitary-adrenal axis in relation to pain from CFS,

• As well as the interactions with immune (dys)functioning…

…require further study.

Conclusion:

Recent research has increased our understanding of pain from CFS, including its treatment.

It is advocated to optimize current CFS treatment protocols by targeting the underlying mechanism for those patients having severe pain.